18 Participants Needed

High Dose Vitamin C for Multiple Myeloma

BS
AH
Overseen ByAaron Holley
Age: 18+
Sex: Any
Trial Phase: Phase 1
Sponsor: University of Arkansas
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether high doses of Vitamin C (High Dose Ascorbic Acid or HDAA), combined with the chemotherapy drug melphalan and followed by a type of stem cell transplant, can safely and effectively treat multiple myeloma that has not responded to other treatments. Multiple myeloma is a blood cancer affecting plasma cells. The trial aims to determine if a lower dose of melphalan combined with Vitamin C is effective and gentler on the body. It is suitable for individuals who have undergone multiple treatments for multiple myeloma and whose disease has worsened in the past six months. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this new therapy.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does exclude those using warfarin and insulin-dependent diabetics. It's best to discuss your specific medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that high-dose vitamin C, administered through an IV, has been safely used in early studies for various types of cancer. Patients in these studies did not report major safety issues, even with doses as high as 1.5 grams per kilogram of body weight, suggesting that the body generally handles high doses well.

For multiple myeloma, a type of blood cancer, high-dose vitamin C has shown potential by possibly helping to kill cancer cells through the creation of harmful substances.

Melphalan, a chemotherapy drug, has already received FDA approval for treating multiple myeloma at higher doses than those used in this study. This trial uses only half of the standard dose, which might lead to fewer side effects.

Overall, both treatments in this trial appear well-tolerated based on previous studies and dosages. However, as this trial is in an early stage, its main goal is to further confirm the safety of using these treatments together.12345

Why are researchers excited about this trial's treatments?

Most treatments for multiple myeloma, like chemotherapy and targeted therapies, focus on killing cancer cells directly. However, high dose Vitamin C, or ascorbic acid (HDAA), offers a unique approach by potentially enhancing the effectiveness of chemotherapy drugs like melphalan. Researchers are excited about HDAA because it could make cancer cells more sensitive to chemotherapy, improving treatment outcomes. The use of high doses of Vitamin C is also intriguing due to its potential to boost the immune system and reduce side effects, offering a complementary approach to traditional treatments.

What evidence suggests that this trial's treatments could be effective for multiple myeloma?

Research has shown that high-dose vitamin C can destroy multiple myeloma cells by producing substances harmful to these cancer cells. In this trial, participants will receive varying doses of high-dose vitamin C combined with the chemotherapy drug melphalan. Studies have found that vitamin C can enhance melphalan's effectiveness, even at lower doses. This combination might reduce the side effects typically associated with high doses of melphalan. High-dose vitamin C also appears to fight tumors by altering cancer cell behavior and strengthening the immune system. While these findings are promising, further research is needed to fully understand its effectiveness in treating multiple myeloma.12367

Who Is on the Research Team?

CS

Carolina Schinke, MD

Principal Investigator

University of Arkansas

Are You a Good Fit for This Trial?

This trial is for adults over 18 with relapsed refractory multiple myeloma who've had at least three prior treatments and disease progression within the last six months. They must have enough stored stem cells, specific levels of proteins or plasmacytosis indicating active disease, and a stable neutrophil count without growth factor support.

Inclusion Criteria

I have given my consent to participate.
I've had 3+ treatments for my condition and it has worsened in the last 6 months.
I have stored stem cells meeting the required count.
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Treatment

Participants receive a test dose of HDAA alone at screening, then proceed to either 75, 100, or 125 gm on day -4, HDAA combined with melphalan 100 mg/m2 on day -1, and ASCT on day 0. Four additional HDAA doses will be administered 3 days apart on D+2, D+5, D+8, and D+11, followed by weekly doses for four additional weeks.

6 weeks
8 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including tumor response, quality of life, and adverse events.

24 months
Regular visits (frequency not specified)

What Are the Treatments Tested in This Trial?

Interventions

  • High Dose Ascorbic Acid (HDAA)
Trial Overview The study tests high-dose ascorbic acid (HDAA) combined with a half-standard dose of melphalan chemotherapy followed by autologous stem cell transplantation. It aims to assess safety, effectiveness in tumor response, minimal residual disease rates, side effects compared to past data, quality of life impact, and oxidative stress changes.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Group I: 75gm HDAA + Melphalan 100mg/m2Experimental Treatment1 Intervention
Group II: 125gm HDAA + Melphalan 100mg/m2Experimental Treatment1 Intervention
Group III: 100gm HDAA + Melphalan 100mg/m2Experimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Arkansas

Lead Sponsor

Trials
500
Recruited
153,000+

University of Iowa

Collaborator

Trials
486
Recruited
934,000+

Published Research Related to This Trial

In a study involving patients with relapsed CD20-positive B-cell non-Hodgkin's lymphoma, intravenous l-ascorbic acid (AA) at a dose of 75 g was found to be safe and successfully achieved the target serum concentration of >15 mM without any observed adverse reactions.
The successful completion of this trial paves the way for a phase II trial to further evaluate the efficacy of intravenous AA in combination with chemotherapy for lymphoma patients.
Phase I Clinical Trial of Intravenous L-ascorbic Acid Following Salvage Chemotherapy for Relapsed B-cell non-Hodgkin's Lymphoma.Kawada, H., Sawanobori, M., Tsuma-Kaneko, M., et al.[2014]
Vitamin C, when loaded into myeloma cells using dehydroascorbic acid, protects these cells from the cytotoxic effects of arsenic trioxide, suggesting a potential strategy to enhance treatment efficacy.
The study found that while vitamin C can generate harmful reactive oxygen species in certain conditions, loading cells with it in a specific way can actually reduce oxidative stress and improve cell viability against arsenic trioxide treatment.
Vitamin C protects HL60 and U266 cells from arsenic toxicity.Karasavvas, N., Cárcamo, JM., Stratis, G., et al.[2021]
An international multi-center study investigated the combination of arsenic trioxide, ascorbic acid, and dexamethasone for treating advanced multiple myeloma, suggesting a potential new treatment strategy.
The study highlights that reducing glutathione levels with ascorbic acid may enhance the effectiveness of arsenic trioxide in inducing growth inhibition and apoptosis in multiple myeloma cells.
Phase II multicenter study of arsenic trioxide, ascorbic acid and dexamethasone in patients with relapsed or refractory multiple myeloma.Wu, KL., Beksac, M., van Droogenbroeck, J., et al.[2018]

Citations

Multiple Myeloma Tumor Cells are Selectively Killed by ...Pharmacologically-dosed ascorbic lowers melphalan dosage. Multiple myeloma (MM) remains a difficult to cure disease in the majority of cases.
Pharmacological dose ascorbic acid administration in ...High-dose ascorbic acid leads to the formation of highly reactive oxygen species due to the pro-oxidant effect, resulting in cell death; therefore, ...
Pharmacologic Ascorbate in Myeloma Treatment: Doses ...Ascorbic acid (vitamin C) has followed opaque paths in treating multiple myeloma, and other malignancies. In myeloma cells, ascorbate ...
Study of High Dose Intravenous (IV) Ascorbic Acid in ...The study is designed to determine if high doses of intravenous ascorbic acid (vitamin C) can be effective in managing solid tumor diseases.
High-dose vitamin C: A promising anti-tumor agent, insight ...High-dose vitamin C exhibits selective anti-tumor effects, including pro-oxidative cytotoxicity, anti-cancer epigenetic regulation, and immune modulation.
High-dose Vitamin C (Ascorbic Acid) Therapy in the ...High-dose vitamin C (typically 10 g/day, by intravenous infusion for about 10 days and orally thereafter) increased the average survival of advanced cancer ...
High Dose Vitamin C for Multiple MyelomaResearch shows that high-dose ascorbic acid can help kill multiple myeloma tumor cells by creating reactive oxygen species that lead to cell death.
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